Robert Kennedy

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

198 Issued in FL

Practice address

313 W Valencia St
Lakeland, FL 33805-3138

Phone

(863) 632-4725

NPI assigned

Aug 20, 2016

Last updated

Aug 20, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471651200000",
    "number": "1588119481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 W VALENCIA ST",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053138",
            "telephone_number": "863-632-4725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 W VALENCIA ST",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053138",
            "telephone_number": "863-632-4725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "ROBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-20",
        "last_updated": "2016-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "198",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "5758",
            "primary": false
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "FL",
            "license": "449",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Marie Kemple, CRNA
• Shantele Louise Kempvanee, DO
• Erica Kendrick, COTA/L
• James Kennedy Jr.
• Rebecca Marie Kennedy, HAS
• Shelby Kennedy, PSYD
• Susan Emily Kennedy
• Kenneth L. Mundy D.D.S., P.a.
• Katera Kennon
• Karlyne Kenny

• Addiction (Substance Use Disorder) Counselor in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Addiction (Substance Use Disorder) Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.